Influence of diabetes on tissue healing in orthopaedic injuries

Clin Exp Pharmacol Physiol. 2018 Jul;45(7):619-627. doi: 10.1111/1440-1681.12939. Epub 2018 Apr 25.

Abstract

Diabetes is a group of metabolic diseases characterized by hyperglycaemia resulting from the defective action or secretion of insulin. Chronic hyperglycaemia can lead to the damage, dysfunction and failure of various organs. In the context of complications of healing and orthopaedic rehabilitation, vascular (microangiopathy) and nerve (neuropathy) disorders deserve particular attention. About 12% of the patients admitted to orthopaedic departments have diabetes. Studies indicate that there is an indisputable link between diabetes and: an increased risk of fractures, the difficult healing of injuries of bones, ligaments and musculotendinous. It appears that one of the main reasons for this is non-enzymatic glycosylation (glycation) of collagen molecules, a phenomenon observed in the elderly and diabetic populations, as it leads to the formation of advanced glycation end products (AGEs). Collagen is one of the major connective tissue components, and is therefore part of ligaments, tendons and bones. AGEs affect the weakening of its structure and biomechanical properties, and thus also affects the weakening of the structure and properties of the above-mentioned tissues. The aim of the study is to undertake an overview of the current knowledge of the impact of diabetes on the risk of some injuries and subsequent healing and rehabilitation of patients following orthopaedic injuries.

Keywords: advanced glycation end products; bone fractures; diabetes; ligament; orthopaedic injuries; tissue healing.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus / pathology
  • Diabetes Mellitus / physiopathology*
  • Humans
  • Orthopedics
  • Wound Healing*